Talking leadership 28: Yukio Yuzawa on dealing with demographic decline

Japanese students are losing out by not studying abroad, Yukio Yuzawa believes. Despite the shrinking numbers of university-aged people in Japan and the threat this poses to higher education, the president of Fujita Health University in Aichi wants students to experience the rest of the world.

“It’s not only due to the Covid-19 pandemic,” Yuzawa says. “Recently, Japanese young generations don’t want to go abroad. This is a big problem.”

In the latest interview in our Talking Leadership series, the trained doctor and kidney specialist discusses the big demographic changes afoot in Japan, the fallout from the 2018 medical school admissions scandal and the future of medicine.

The benefits of internationalisation

Students in other Asian countries, such as China and Korea, study abroad in droves and then return to their home countries to be leaders in their fields. Japan, too, used to embrace this tradition, but due to an economic downturn during the past few decades, students have been staying put, Yuzawa says. This applies not only to whole courses abroad but also to studying abroad for semesters, he adds.

They are missing out on the mentors they could meet and the global network of future experts in their field. But, most importantly, students are not realising that the Japanese way of doing things is not the only way.

“There is a big discrepancy between the Japanese common sense and the world, universal common sense,” he says. “We should not follow the thinking way of the UK or the United States. We should keep our own Japanese system. But we should know the weak points and also the advantages of the Japanese system. If we don’t go out [abroad], we don’t have the chance to learn about it.”

At Fujita Health, a medical university that ranks in the 151-200 band in the Times Higher Education Japan University Rankings, international exchanges will be reinstated as soon as Covid allows.

Demographic change

Demographic changes in Japan are having a profound impact on every area of Japanese society, not least higher education.

In January, government figures reported that the number of Japanese citizens aged 20 had fallen to about 1.2 million – 40,000 fewer than the previous year and the lowest since the survey began in 1968.

The number of children aged 14 or younger is also declining, with 14.9 million recorded in 2021, 190,000 fewer than the year before. This took the proportion of children within the overall population to its lowest point, 11.9 per cent, following 47 straight years of decline. This is the lowest share of children among the 33 countries with a population of over 40 million, below South Korea’s 12.2 per cent and Italy’s 13.3 per cent, according to the United Nations’ Demographic Yearbook.

Yuzawa is worried about the impact that this will have on educational standards, saying that universities are admitting less-capable students to fill their places. This is only likely to get worse, he believes.

He acknowledges that universities need to do more to bring less-capable students up to standard, and adds that structural changes are happening, too. Departments and resources are being merged across universities to meet the decreased levels of demand.

Meanwhile, university leaders have been given more autonomy to make changes at their institutions – a shift that Yuzawa, perhaps unsurprisingly, sees as a good thing and one that will enable presidents to guide their universities to develop new areas of research and study.

“We need to restructure the universities. Each school needs to be structured according to the changes in the society,” he says. If Japanese universities do not reorient towards the latest research areas, such as big data, he worries that they will fall behind higher education institutions in the rest of the world.

As a trained doctor and medical academic, Yuzawa believes that changes are needed in medical education, too. Before he became president of Fujita Health, he ran a hospital and he believes that there is not enough crossover between clinical practitioners and research. In Japan there are excellent medical researchers and excellent physicians, but the country lacks physicians who also do research, he says.

“This kind of physician is very important to us to promote advanced medical care,” he explains, adding that he admires the UK and US system of doctors taking research sabbaticals.

Fujita Health University is hosting the THE Asia Universities Summit this week, where delegates will explore how Asian universities need to adapt and provide learning opportunities that will upskill the people in the societies that they serve.

Yuzawa believes lifelong learning will be very important, but he thinks that Japanese society will need to adapt to embrace it. Japanese companies tend to provide steady jobs for life, undermining the need for upskilling, he says. 

Medical school scandal

In 2018, Japan’s academic world was shocked when a government investigation revealed that medical schools had been manipulating admissions to exclude female students, apparently over concerns that they would not go on to practise medicine.

Fujita Health was not one of the nine universities found to have discriminated against women, but as part of the medical community, what impact did the scandal have? Things “dramatically changed”, Yuzawa says. Medical schools now have to publish entry rates by gender, and the data show these are now roughly equal.

And what of the wider issue of women studying but not pursuing careers in medicine? “Japanese husbands usually don’t help,” he says.

Yuzawa’s younger female colleague, who is sitting in on the interview to help interpret if needed, interjects: “You would be surprised how much husbands are useless in Japan. At home, they’re just sitting and watching TV – and everything like cooking, taking care of children, mothers do,” she says.

The culture is shifting with the younger generation, though, Yuzawa and his colleague agree. Yuzawa believes that physician roles also need to change because they are too demanding for someone to have a family at the same time. 

Medicine, too, is changing and Yuzawa’s eyes light up as he describes the developments that he is excited about: big data, regenerative stem cell organ therapy and robotic surgery are some of the areas, along with new drugs that will be able to “completely cure every type of cancer”.

Yuzawa went into medicine, he says, because it combines continual learning with care for others. “Medicine is a rewarding profession to continue for a lifetime.”

Quick facts

Born: Nagano Prefecture in Honshu island, 1968

Academic qualifications: MD and PhD from Nagoya University's School of Medicine

Lives with: Alone

This is part of our “Talking leadership” series of 50 interviews over 50 weeks with the people running the world’s top universities about how they solve common strategic issues and implement change. Follow the series here.

The THE Asia Universities Summit, in partnership with Fujita Health University, is taking place from 31 May to 2 June.